Max R. Lehfeldt, MD • Pasadena, California

Revision abdominoplasty using SERI^® Surgical Scaffold for soft tissue support and repair

Operative technique

Step 1: Hernia repair and plication
The umbilical hernia repair was followed by an abdominal wall plication using figure-of-8 sutures and a running knotless tissue closure to reinforce the hernia repair and support lax tissues.

Step 2: Overlay placement and orientation of SERI^® Surgical Scaffold
A 10 cm x 25 cm sheet of the scaffold was used. The corners were trimmed to fit the contours of the abdominal wall. The scaffold was oriented vertically, centered over the midline, and tacked in place.

Step 3: Suture SERI^® Surgical Scaffold
The scaffold overlay was tacked with 2-0 synthetic absorbable PDS sutures to anchor the material in place and stabilize the scaffold during tissue ingrowth. The scaffold was then inset with tension using 0-Vicryl^® running sutures circumferentially. SERI^® Surgical Scaffold was plicated over the midline repair to the underlying abdominal fascia using running sutures to provide additional abdominal contouring.

Step 4: Expose the umbilicus
A small slit was cut in the scaffold and the umbilicus was pulled through. A suture was placed into the umbilical dermis to help facilitate the final position of the umbilicus.

Step 5: Closure
A single drain was inserted in the lower abdomen through a stab incision. 2-0 synthetic absorbable PDS was used to close Scarpa’s fascia, followed by 3-0 Monocryl^® for the deep dermis, and Monoderm^® sutures to close the skin. Steri-Strip^® and supportive dressings were applied, with an abdominal binder for additional support.